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Ann Thorac Surg 2004;78:1484-1485
© 2004 The Society of Thoracic Surgeons

How to do it

A Method to Avoid Annular Downsizing During Knot Tying

Francesco Maisano, MDa,*, Andrea Blasio, MDa, Alessandro Caldarola, MDa, Carlo Savini, MDa, Ottavio Alfieri, MDa

a Department of Cardiac Surgery, San Raffaele Hospital, Milan, Italy

Accepted for publication August 28, 2003.

* Address reprint requests to Dr Maisano, Cardiochirurgia, Ospedale San Raffaele, Via Olgettina 60, 20132 Milan, Italy
francesco.maisano{at}hsr.it

Pericardial annuloplasty has been used as an alternative to prosthetic annuloplasty. One drawback of pericardial annuloplasty is the risk of cinching of tissues during knot tying, possibly leading to uncontrolled downsizing and to complications such as mitral stenosis and systolic anterior motion of the anterior leaflet. A simple modification of the sequence of knot tying is described to avoid this complication.




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